ABSTRACT
Anti-Ro autoantibody is associated with Sjogren's syndrome (SS), systemic lupus erythematosus (SLE), and neonatal lupus syndrome (i.e., congenital complete heart block in newborns). Generally, the adult atrioventricular (AV) node is believed to be relatively resistant to the scarring effects of anti-Ro/anti-La autoantibodies. However, there have been some reports of adult complete AV block in SS and SLE patients. Here, we report a case of complete heart block in primary SS with anti-Ro autoantibodies, with no other risk factor for the development of heart block, and review their etiological association.
Subject(s)
Female , Humans , Middle Aged , Antibodies, Antinuclear/blood , Atrioventricular Block/diagnosis , Cardiac Pacing, Artificial , Electrocardiography , Electrocardiography, Ambulatory , Exercise Test , Predictive Value of Tests , Risk Factors , Sjogren's Syndrome/complications , Treatment OutcomeABSTRACT
BACKGROUND/AIMS: We wanted to compare the efficacy and safety of a Murupe(R) patch, which is a newly-developed piroxicam patch, with the Trast(R) patch for the treatment of knee osteoarthritis. METHODS: Two hundred ten patients with radiologically confirmed symptomatic osteoarthritis of the knee were included in a randomized, open-labeled controlled trial and they were treated with a 48 mg piroxicam patch once every 48 hours for 4 weeks. The main outcome measures were the pain intensity on movement and the spontaneous pain intensity during rest, and these were measured using the 10 cm Visual Analogue Scale (VAS) categorical pain scores, as measured by the patient and the investigator. RESULTS: One hundred sixty-seven of the 210 enrolled patients completed the 4 week study. The pain intensity on movement was significantly reduced in both the Trast(R) and Murupe(R) groups (p<0.001) after 4 weeks of treatment; the improvement on the VAS was significantly higher in the Murupe(R) group (n=82) than that in the Trast(R) group (n=85) (4.5 cm versus 2.2 cm, respectively, p<0.001). Both treatment groups also showed reductions in all the other parameters of pain intensity, including spontaneous pain intensity during rest, the categorical pain scores and the 15 meter-walking time. There was no difference in adverse events between both groups. CONCLUSIONS: The superior analgesic activity of Murupe(R) patch indicates that the topical route of non-steroidal anti-inflammatory drug (NSAID) administration may be a safe, effective alternative to the oral route for the treatment of knee OA, and that the newly developed NSAID patch with its improved transdermal drug delivery may increase the efficacy of topical NSAIDs.